Guy Micco, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G30291 Issued in CA

Practice address

570 University Hall SPC 1190
University of California, Berkeley
Berkeley, CA 94720-1190

Phone

(510) 643-0667

Fax

(510) 841-6929

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Gaetan (Guy) Paul Micco Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1881718807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 UNIVERSITY HALL # 1190",
            "address_2": "UNIVERSITY OF CALIFORNIA, BERKELEY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947200001",
            "telephone_number": "510-643-0667",
            "fax_number": "510-841-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 UNIVERSITY HALL SPC 1190",
            "address_2": "UNIVERSITY OF CALIFORNIA, BERKELEY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947201190",
            "telephone_number": "510-643-0667",
            "fax_number": "510-841-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICCO",
        "first_name": "GUY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G30291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAETAN (GUY)",
            "last_name": "MICCO",
            "middle_name": "PAUL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anne Meyers, L.AC.
• Gerald L. Meyers, M.D.
• Sharon Meyers, LCSW, MSW, MPH
• Daniel Christopher Meza
• Mark Mezak
• Michael Clark Marriage and Family Therapy, Inc
• Michael G Kiyomoto OD
• Michael Nian Peng Shi, L.Ac., PH.D.
• Nathan Michael, M.A.
• Bronwyn Gay Michaelis, LAC

• Internal Medicine Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.